RESEARCHUPDATE.MCCOYPRESS.NET

Ernst Slams Chiropractic for Children

Matthew McCoy DC MPH — Thu, 29 Jul 2010 14:21:00 GMT

I've been sounding the alarm about the need for chiropractic research for about 20 years now. Over that timeframe the situation has become more and more serious. An increasingly skeptical public, the shift to accountability in health care and the understanding that the consumer should not pay for what does not work are some of the reasons why things have become so serious.

Organized medicine, while certainly behind along with everyone else in the era of evidence, for the most part embraces such a shift and has already geared up and gotten underway to engage in the process. For the most part they do not have a cultural problem when it comes to research.

The chiropractic profession on the other hand is a different story. Our profession, for the most part, does not embrace research. In fact the culture in our profession is one of disdain when it comes to the topic. We do not value it and therefore we do not engage in the enterprise.

One of the only pieces of evidence on research infrastructure within chiropractic revealed that the profession has less than 70 full time researchers. We know that the chiropractic profession has received less than $50 million from the NIH in the entire 100+ years of its existence and we also know that less than 7% of the profession subscibes to a peer reviewed research journal.

Some say we don't need research. That the public wants us and that's all we should care about. Well setting aside for a moment the very small number of chiropractors seeing over 100 visits a week and understanding that the profession's market share has not grown in at least 40 years one has to conclude that the profession as a whole has a serious problem.

A recent paper on systematic reviews of the literature by Ernst had the following conclusions regarding the literature supporting chiropractic care for children:

Results were mixed and unconvincing.
Studies were methodologically poor
Those that had good methodology did not suggest chiropractic was effective
None used validated outcome measures
There are no RCTs of chiropractic for otitis media, despite the claims made by chiropractors that it is an effective treatment for that condition.
Insufficient data to recommend chiropractic as an effective treatment for nocturnal enuresis in children.
Conflicting results for the treatment of asthma

The authors made this final point about chiropractic for children:

Moreover, adverse events of CAM extend beyond the actual treatments themselves. It hasbeen shown that children who consult naturopathy and chiropractic practitioners are signifi cantly less likely to receive the recommended vaccinations and were significantly more likely to be diagnosed with a vaccine-preventable disease.

Over the past 20 years that I've been advocating an intense focus on chiropractic research those admonitions were focused heavily on subluxation based research. Several years ago as the dire nature of the situation became clear to me I further focused my exhortations towards the need for chiropractic research that focuses on health outcomes related to subluxation in pregnant women and children. My reasoning is that given the short amount of time we have to provide the level of evidence that is needed this is the population we should focus on.

So, what can you do to help? Remember what I said earlier about less than 7% of the profession subscibing to a peer reviewed research journal? Here is what you need to do:

1. Join the ICPA and get involved in their research efforts
2. Subscribe to a peer reviewed chiropractic research journal

In order to make your decision about supporting this journal easier please take advantage of this special Mid-summer offer to become a subscriber. If you subscribe to the journal now I will send you, absolutely free, 2 PowerPoint presentations titled:

Raising a Healthy Child in an Unhealthy World
The Role of Chiropractic in Neurobehavioral Disorders - Part I: ADHD

CLICK HERE TO SUBSCRIBE!

The crucial need for chiropractic research alone should compel you to subscribe and support the efforts of those in the profession trying to gather the data to support what you do day in and day out but hopefully this added special offer will make it a no brainer. Your actions today help support needed research for the future.

And while you're at it please forward this e-mail to a colleague so they can benefit from this special offer.

As always I look forward to your feedback, comments and suggestions.

Matthew McCoy DC, MPH
matthewmccoy@comcast.net
Editor - Journal of Pediatric, Maternal & Family Health - Chiropractic
http://www.chiropracticpediatricresearch.net

I Think Their Heads Rattle When They Shake Them

Matthew McCoy DC MPH — Sat, 10 Jul 2010 19:10:00 GMT

"Historically, power complexes begin to falter long before the ruling elite realizes that the oppressed are organizing."

William B. Ferril, MD

I know its cliche - but just when you thought the General Chiropractic Council could not make more bizarre statements than they have already made - they provide more giggles and grins.

But beyond the giggles and grins, the actions being taken by the GCC are serious and have serious repercussions for those practicing in the United Kingdom and indeed throughout the world.

In a response to a letter written to the GCC asking them to reconsider the errors of their ways as well as evidence contradicting their "Guidance" on vertebral subluxation, the GCC opined that after further consideration by the Anglo-European College of Chiropractic that:

"...there is, in fact, no evidence for support of this concept."

The "concept" at issue being that there is a relationship between subluxation and health concerns.

But then they take the public display of their ignorance of these matters one step further and state:

"Again, the only way to definitively show if the putative spinal lesion has health promoting effects and is as dangerous as some claim is through clinical trials using randomized controlled design."

First, they should get someone to proofread their stuff since I don't know anyone who is claiming that subluxations actually improve health. And second, anyone even remotely familiar with research methodology at this point should know that RCT's are not the only way to determine correlations such as these. Further, the GCC should also know that you cannot "definitively show" anything. All you can do is show varying levels of correlations, probabilities etc. You can never prove causation as any first year biostats student can tell you.

Scientism at its finest - or should I say worst since they can't even seem to get the science right.

The bottom line is that the Golden Rule prevails here - He with the most gold - rules. And since the GCC has the gold in the way of the annual registration fees of the practicing chiropractors in the UK - they have the money to promote (ahem - enforce) their agenda.

Let's hope and pray for all our sakes and the sick and suffering patients we serve, that the oppressed chiropractors in the UK are indeed organizing.

Additional Links on the GCC Controversy:

Matthew McCoy DC, MPH

matthewmccoy@comcast.net
Editor
Journal of Pediatric, Maternal & Family Health - Chiropractic
http://www.chiropracticpediatricresearch.net

Oprah Will Save Chiropractic - Really?

Matthew McCoy DC MPH — Thu, 01 Jul 2010 13:27:00 GMT

You may have heard that Oprah is having another one of her contests and is looking to find a new personality to star in their own show when she launches her new network.

I have been inundated on a daily basis for the past several weeks with e-mails from chiropractors (even leaders within the profession) asking me to go and vote for this or that chiropractor that they think should win.

Beyond the narcissism in these reality television, talent contests, survivor shows etc., what amazes me is that chiropractors actually think that getting a chiroprator on Oprah is going to save this profession.

And please don't write me and tell me about all the careers she has launched and best selling books she has put on the lists, yada, yada, yada.

Once more let's get this straight:

The future of the chiropractic profession rests on its ability to demonstrate improved health outcomes secondary to reduction and/or correction of vertebral subluxation coupled with its ability to communicate that benefit and provoke outrage within the public to the extent that they perceive there is a hazard of leaving verterbral subluxation unattended.

This is the only thing that is going to move us from seeing less than 10 percent of the population - the early adopters - and move on to the rest of the population. Oprah won't do it, being primary care physicians won't do it, prescribing drugs won't do it...

The perfect storm of the health care collapse consisting of unsustainable spending, GDP percentage approaching 20+ percent, entitlements, social security, aging baby boomers, Medicare and Medicaid is coming in the next 20-30 years. We'll either be out in front of it or we will be swept up in the tidal wave of reform.

While Oprah has miracle powers, she does not have influence over 20 + percent of the gross domestic product of the country. I beleive that intellectually chiropractors know this but deep down from the roots of our profession we are always looking for that one charismatic person who rides in on a white horse to save us from our oppressors.

I got news for you - NO ONE IS COMING TO SAVE US.

And that includes the entrenched leadership within the profession which is perfectly happy with the status quo - 30 years from now they will effectively be gone and had their fill of the bounty of this profession.

Well - the status quo has to go. And the only way it will happen is for each and every one of you to get engaged in the process.

Or we could pin our hopes on Oprah.

Are you in?

Matthew McCoy DC, MPH
matthewmccoy@comcast.net
Editor
Journal of Pediatric, Maternal & Family Health - Chiropractic
http://www.chiropracticpediatricresearch.net

How Much Stupidity Will We Put Up With?

Matthew McCoy DC MPH — Wed, 23 Jun 2010 20:28:00 GMT

I told the graduating class at Life University durig my speech at their Awards Ceremony last week that they have the distinction of graduating just as chiropractic is no longer a drugless profession, philosophy has been removed from the curriculum in the United Kingdom and talk of a nexus between subluxation and health is no longer allowed there. Similar events are occurring in Australia and in the US.

Thankfully, the Foundation for Vertebral Subluxation has responded to all of these recent issues. Just last week it issued a response to the United Kingdom's chiropractic regulatory authority and their statement that there is no evidence that subluxation has any relationship to health concerns. In fact the Foundation's President, Dr. Christopher Kent took it a step further and wrote a detailed, point by point analysis of the GCC statement.

If you have not read the Foundation's response and Dr. Kent's Analysis - you should. But just in case, I'll give you the Cliff Notes version:

You can't just make crap up!

And this is exactly what the General Chiropractic Council did.

While we are all affected by what the GCC has done it remains to be seen whether or not the chiropractors in the UK will come out swinging or not. If there was ever a time and if there was ever an issue where their regulatory board does not have a leg to stand on - this is it and they should be all over it like a pit bull on crack.

As Dr. Kent suggested - it's as if they were contending the earth was flat.

That is how ridiculously stupid this is.

As always I look forward to your feedback, comments and suggestions.

Matthew McCoy DC, MPH
matthewmccoy@comcast.net
Editor
Journal of Pediatric, Maternal & Family Health - Chiropractic
http://www.chiropracticpediatricresearch.net

The Attack on Real Chiropractic

Matthew McCoy DC MPH — Sun, 06 Jun 2010 21:36:00 GMT

Yes, I know that there will be those in the profession who will denigrate me for suggesting that I know what "real chiropractic" is. I'm happy to take them on considering I've formally been in this profession for 20 years and you can add another 15 for the time prior as a patient.

Plus, only the most rabid anti-chiropractor secretly (or openly) wishing for the profession to go the way of the dodo bird would encourage, endorse or otherwise sanction the lunacy that's been taking place recently.

You may have heard about the recent statement by the General Chiropractic Council in the United Kingdom that the subluxation theory "...is not supported by any clinical research evidence that would allow claims to be made that it is the cause of disease or health concerns."

Or you may have heard about the new proposed code of conduct in Australia that has chiropractors there worried about restricting the forms of advertising used, curtailing wellness type care, discouraging the recommendation that parents get their kids checked regularly and even that chiropractors will need to be up to date on all vaccines.

Or you may be aware that chiropractic can no longer claim to be a drugless profession as some of our bretheren in several states push for prescriptive rights - and in some cases have gotten it. Dr. Gerry Clum summed up the drug issue nicely recently: "For my nickel, this is the most dangerous movement I have ever witnessed in my 40-year career in chiropractic."

Or you may have read the recent commentary by Simon French, Bruce Walker and Stephen Perle in

Chiropractic & Osteopathy titled "

Chiropractic care for children: too much, too little or not enough?" in which the authors state after lamenting about the paucity of chiropractic pediatric research:

"Thus it may also be reasonable to suggest that a short trial of 'placebo treatment' is warranted!"

The wheels appear to be coming off the wagon.

The bottom line is that all forms of chiropractic research and political advocacy is crucial to our survival at this point. But, for a profession that suggests its littlest patients are its most important - the situation is even more serious and acute.

I'm urging you to do three things right now:

If you are not already a member - Join the International Chiropractic Pediatric Association (ICPA)
If you are not already - become a subscriber to the Journal of Pediatric, Maternal & Family Health - Chiropractic (JPMFH)
If you are not already - become a supporter of the Foundation for Vertebral Subluxation

We desperately need a strong organization that champions the care of our most important patients, we desperately need a research journal that publishes the evidence to support the right to provide that care and we desperately need a think tank devoted to vertebral subluxation.

Please do these three things today.

If you are already an ICPA member a JPMFH subscriber and a Foundation supporter - THANK YOU!

As always I look forward to your feedback, comments and suggestions.

Matthew McCoy DC, MPH
matthewmccoy@comcast.net
Editor - Journal of Pediatric, Maternal & Family Health - Chiropractic
http://www.chiropracticpediatricresearch.net

The Death of the Subluxation

Matthew McCoy DC MPH — Wed, 19 May 2010 22:08:00 GMT

This has been one hell of a spring and as we slink into the summer it seems the rancor in the profession is heating up as well. We are no longer a drugless profession, nothing other than musculoskeletal claims can now be made, the "united profession" has taken up the role of physician as a national legislative priority and rumors are that the state regulatory bodies in the US are working on defining chiropractic in a whole new light.

In what will no doubt become a major historical event in the history of the chiropractic profession the United Kingdom's General Chiropractic Council has declared that there is no research to support the vertebral subluxation as a cause of health concerns.

Some are heralding it as the death of the subluxation.

It appears that following the Simon Singh case and the release of the Bronfort Report numerous complaints have been filed against chiropractors for claims being made other than those on the short list allowed in the Bronfort Report.

The GCC made the subluxation statement in a response to an enquiry by a member of the public. In addition to the statement about subluxation and health concerns the GCC stated that subluxation was "...synonymous with joint misalignment, joint dysfunction, facet syndrome and articular derangement."

There is certainly no mention of the imprisoned impulse!

Keep in mind that the GCC made this statement after consulting with the chiropractic educational programs in that country.

It appears that these institutions teach subluxation within a historical context - i.e. we used to believe...

You know - like we used to beleive the earth was flat.

I trust everyone understands the significance of the GCC making such a public statement.

Still don't think the sky really is falling?

As always I look forward to your feedback, comments and suggestions.

Matthew McCoy DC, MPH
matthewmccoy@comcast.net
Editor
Journal of Pediatric, Maternal & Family Health - Chiropractic
http://www.chiropracticpediatricresearch.net

The Bronfort Report, the UK and the Aussies – I Told You So…

Matthew McCoy DC MPH — Fri, 14 May 2010 21:21:00 GMT

“Goodness gracious me!” said Henny- penny; “the sky’s a-going to fall; I must go and tell the king.”

Yes, we all remember that fateful day when an acorn hit Henny Penny on the head and she along with Cocky-locky, Ducky-daddles, Goosey-poosey, Turkey-lurkey and Foxy-Woxy went off to tell the king.

Unfortunately it was off with their heads.

For some time now I’ve been running around like Henny Penny, Chicken Little and any other character who thought there was some impending doom pressing down upon us. But unlike the boy who cried wolf, what I’ve been warning about within the profession has systematically come to pass and the only ones getting their heads lopped off are chiropractors.

The current brouhaha involves a myriad of interconnected issues including the introduction of drugs into chiropractic in at least three states that we know of, the imbroglio in Texas between the Texas AMA and the chiropractic board (which apparently began over the issue of MUA and will no doubt spread to other states) and the full scale adoption of primary care physician status as one of the top priorities of a United Chiropractic Profession

As if we needed any more acorns hitting us on the head!

Nevertheless the Brits and Aussies were happy to oblige. First we had the Simon Singh fiasco which has morphed into a large scale attack on the chiropractic profession in the UK with rumors circulating that anything beyond the treatment of neck and back pain will be outlawed.

Indeed, in a report written by Gert Bronfort and commissioned by the United Kingdom’s General Chiropractic Council only the following conditions can be advertised:

 Acute, subacute and chronic low back pain;
 Migraine
 Cervicogenic headache
 Cervicogenic dizziness
 Extremity joint conditions
 Acute/subacute neck pain
 Chronic neck pain

Fears of large scale rounding up of chiropractors who have anything about wellness or subluxation based care on websites are heavy on the minds of chiropractors on the other side of the pond.

This of course because there are not enough (or any) RCT’s for anything else chiropractors claim to treat. What makes this really scary is that it appears the powers that be are moving beyond this to make chiropractic care, or claims, for general health improvements off limits as well.

Makes me recall the sage advice of Ian Grassam DC - "Stick to subluxation and they can't touch you"

The rumors are that in Australia, the Board is proposing changes that include restricting the forms of advertising used, curtailing wellness type care, discouraging the recommendation that parents get their kids checked regularly and even that chiropractors will need to be up to date on all vaccines.

I know some of you right now are swooning at the thought of such things and righteous indignation is setting in as you harrumph, harrumph wildly while reading this but can you honestly say you did not see it coming?

Are you going to try and convince me that you were not aware that the controlling cartel in this profession has a plan and it does not include what you hold so dearly? I guess I could forgive you if you’ve been held hostage by a water boarding Jack Bauer in some underground warehouse.

But its time to wake the hell up folks! The Dark Side’s ducks are all in a row. It’s done, over with, kaput. The only thing left is for them to put it into play and that’s what they are doing now.

What we see happening now is the bringing to market the harvest of the seeds that have been sown over the past 20 years by those whose agenda was to seek control of the profession as a short term treatment for musculoskeletal pain. All the while the leadership in the subluxation camps told us we needed to stay involved with them because we could “change it from within” - in the immortal words of Dr. Phil: “How’s that workin’ out for ya?” If you can’t connect the dots you didn’t watch enough Sesame Street.

So where does all this leave us? Pick up your pitchforks and torches and get ready to storm the castle and avoid like the plague anyone who says we can change them from within. Anyone who says that has their own agenda and their own retirement they are worried about. Nothing short of a revolution in this profession is going to right this ship. And those that don’t want it are just too concerned about whether or not there will be enough lifeboats for them.

Subluxation, family wellness focused chiropractors need to take over the regulatory boards, agencies and organizations in this profession – “Trow da bums out!” so to speak. You may not agree with the teabaggers but they are being effective.

We need a massive research effort like never before seen (focused on subluxation, Quality of Life & health outcomes) and we need a massive public relations/marketing program to go along with it. This marketing campaign needs to do what health communications experts call “provoke outrage” but unfortunately this is exactly what the regulatory boards have outlawed.

To recap:

1. Politics – Trow da bums out
2. Research – Subluxation & health outcomes
3. Marketing – Provoke outrage

Spinal manipulation?

The PT’s are coming, the DO’s are going back to their roots and the MD’s can learn it at Harvard now.

How long will it be before they see a “miracle” scratch their heads and say “hmmmm - there must be more to this after all”.

As always I look forward to your feedback, comments and suggestions.

Matthew McCoy DC, MPH
matthewmccoy@comcast.net
Editor
Journal of Pediatric, Maternal & Family Health - Chiropractic
http://www.chiropracticpediatricresearch.net

How Long Will Chiropractic Remain a Separate and Distinct Profession?

Matthew McCoy DC MPH — Sat, 01 May 2010 19:41:00 GMT

I don't believe I've received as many letters about any single topic in the nearly 20 years I've been writing within the chiropractic profession as I have on the issue of tiering and drugs. I've heard from long lost friends, classmates, students, academics, researchers, college presidents and every other part of the chiropractic spectrum. I've heard from those both for and against and from those who simply don't care (not sure why they wrote then). Some have been downright nasty and unprofessional. Makes you wonder.

The majority of the feedback I have received has actually been pro drug and pro tiering. I can only hope that those who oppose such efforts are simply apathetic and that's why we've not heard much from them. While it might seem strange to hope for apathy, the alternative is perhaps worse - that those who oppose drugs and tiering of the profession really are in the minority.

It certainly jives with the only data we have on this from the McDonald Ohio Northern University study which said about 50% of the profession wants to be able to prescribe drugs. Since it’s been a number of years since that study was published it would not be a stretch for that percentage to have grown and given the current economic circumstances and the changing demographics of the profession I suspect the number of chiropractors willing to abandon its drugless nature has indeed grown.

In the April/May issue of Today's Chiropractic there are two essays on the topic of tiering, drugs and the loss of the separate and distinct nature of the chiropractic profession. One is by Joseph Brimhall DC, President of the University of Western States and the other by Rob Sinnot DC, one of the leaders within the Chiropractic Philosophy Diplomates. If you get Today's Chiropractic you can read these articles for yourself or you can "Friend" Dr. Sinnot and read them on Facebook

Here’s my summary of Dr. Brimhall’s pro-drug/pro-tiering argument:

1. We need to accept and understand change
2. Chiropractic has endeavored to be separate and distinct since its beginning
3. Authority to establish scope of practice and chiropractic definitions are assigned to the states
4. Lawmakers, government administrators and the public decide our scope and how we are defined
5. We'll remain viable and distinct as long as we meet the needs of the public
6. Scope changes (such as bringing drugs into the profession) is not tiering or an indication of superiority because the individual chiropractor can narrow or broaden their scope as they desire within the law.
7. Failure as a profession will come only if we abandon the needs of our patients in favor of our personal definitions of chiropractic.
8. Some patients require more invasive procedures so why shouldn't we provide them?
9. If we are more concerned about our identity then the needs of our patients we have already lost
10. We should become part of the health care solution and worry about distinction later.

Let me state at the outset that I respect Dr. Brimhall and the work he does within the profession and I believe that he really cares deeply about the profession and the public. He has fought hard for reform within the profession and I do not think that his opinions reflect anything other than a sincere interest in professional stewardship.

I could not agree more that we need to accept and understand change. I suspect it’s what we do about changes occurring outside of our direct control that is the real issue. The facts are that people want drugs. There are six drive-thru pharmacies between my house and the main highway. But I don't think this fact means we should provide those drugs.

Dr. Brimhall states, the “…chiropractic profession has endeavored to remain separate and distinct since its beginning…”

While there are many facets of that distinctiveness I think it could be reasonably argued that the most significant is the drugless nature of the profession.

What I find myself reminding people of these days is that the potential for chiropractic to no longer be a drugless profession is not some vague possibility off in the distant future – it has already happened. With the events that have taken place in New Mexico, the similar efforts being undertaken in Colorado and Utah, and National’s establishment of an Advanced Practice Degree - the profession can no longer claim to be drugless. In fact, it appears we have quite a contradiction on our hands considering all of the associations, organizations, schools and trade groups that proudly proclaim that the profession is drugless. All of this has to now be re-written. Talk about confusing the public! We‘ve gone from a profession suffering from a multitude of neurotic tendencies to a complete psychotic break.

Dr. Brimhall argues that the “…authority to establish scope of practice and chiropractic definitions are assigned to the states and that lawmakers, government administrators and the public decide our scope and how we are defined…”

While this might be true I doubt the general public is storming statehouses with pitchforks and torches demanding that chiropractors prescribe drugs. Of all of the arguments I’ve heard this is stretching it the farthest.

The general consensus among those I’ve heard from, or in articles I’ve read in support of drugs in chiropractic, appears to be that it makes financial sense. Yes, as always – its all about the Benjamins baby. You see, the ability to prescribe drugs and the ability to perform injections opens up additional diagnostic and procedural codes for us to bill insurance carriers. The Mercedes 80’s generation of chiropractors just cannot give up on finding more and more creative ways to get money from third parties. And I’m sorry but no one is going to convince me that if the prospect of increased revenue were not in play that we would even be having this conversation. The pro-drug movement should just admit this outright.

Dr. Brimhall asserts that we'll “…remain viable and distinct as long as we meet the needs of the public.”

I’ve heard this argument many times from the pro-drug wing – but it doesn’t make sense to me. First, it supposes that the public needs drugs – or least they need us to provide them with drugs. Not sure about you but it seems to me that the medical-pharmaceutical-industrial complex is doing just fine providing drugs to folks. Is the public really in such dire need of more drugs that arguably the most powerful industry in the world needs the help of 40,000 chiropractors to help market and deliver their product?

We’ll remain viable as long as we provide our unique (distinct) service to the public and educate them about what exactly that unique service is. And it’s not the episodic treatment of musculoskeletal pain syndromes, weight loss, exercise, proper diet, vitamins, proper sleep or a positive mental attitude.

Dr. Brimhall contends that scope changes (such as bringing drugs into the profession) “…are not tiering or an indication of superiority because the individual chiropractor can narrow or broaden their scope as they desire within the law.”

If only this were true. I’m not saying the following to impress anyone but only to impress upon you that I just might have a little experience in this area. For nearly 20 years I have served as an expert witness and/or consulted on behalf of chiropractors battling malpractice, regulatory and insurance issues. We’re talking thousands of cases at this point. Anyone with half his wits about him knows that this profession is controlled by the more medically oriented faction of the profession. They control the state boards, they control the schools, they control accreditation and licensing and they control the research infrastructure.

To suggest that the more conservative factions of our profession should just trust that these entrenched powers will allow one to practice a narrow scope focused on the analysis and correction of subluxation is simply insulting. We are talking about the same entrenched powers that have historically, and up to the present day, sought to exterminate the more conservative factions.

Failure as a profession, Dr. Brimhall suggests, “…will come only if we abandon the needs of our patients in favor of our personal definitions of chiropractic.”

I could not agree more.

Every single national and international chiropractic organization has endorsed the ACC Paradigm Statement. This statement, developed and signed by the Presidents of all of the North American Chiropractic Colleges, has enjoyed unprecedented endorsement throughout the chiropractic profession. It has received such widespread support that some have remarked that never in the history of the profession has there been this extent of agreement on anything. This statement has been endorsed and/or adopted by every major national and international chiropractic organization in the profession including:

The World Federation of Chiropractic
The Congress of Chiropractic State Associations
The Association of Chiropractic Colleges
The Foundation for Chiropractic Education & Research
The Federation of Chiropractic Licensing Boards
National Board of Chiropractic Examiners
The National Association of Chiropractic Attorneys
The Council on Chiropractic Practice
The Council on Chiropractic Education
The International Chiropractor's Association
The American Chiropractor's Association

The ACC Paradigm states:

Chiropractic is a health care discipline which emphasizes the inherent recuperative power of the body to heal itself without the use of drugs or surgery.

As I said – the profession has some rewriting of its basic premises to do.

The point is that we’re not even talking about personal definitions of chiropractic – this one is signed by everybody!

The repeated mantra from the pro-drug rally that we are abandoning the needs of our patients by not providing them with drugs makes no sense – and making matters worse the profession has abandoned its own paradigm to do so.

But expediency seems to rule the day as Dr. Brimhall argues that “…some patients require more invasive procedures so why shouldn't we provide them?”

Some patients need their tires rotated – should we do that too?

Stating that if we are “…more concerned about our identity then the needs of our patients we have already lost,” Dr. Brimhall brings forth a common argument I hear on this issue.

I suggest that being concerned about our identity is part and parcel to being concerned about our patient’s needs. We’re talking about identity here. Ever deal with someone who didn’t know who they were? As Dr. Gerry Clum recently wrote on the issue of drugs:

“This only serves to strengthen my perspective that this is an area of health care (drug use) better left to others totally immersed in it, trained in it and supervised heavily in it.”

Are we really trying to convince people that 12, 24, 36 or 48 weekends in a Holiday Inn learning how to prescribe and inject drugs qualifies us to do it? People better start reading the briefs on the AMA v. Chiropractic in Texas. The full body diagnosis and treatment charade is about to end for everyone. You mean I can get into chiropractic school, spend $200,000.00, have 300 patient visits, graduate and then diagnosis and treat the human body when I get out just as much as I could if I went to Harvard Medical School? Who do we think we’re fooling? This is just further evidence of our break with reality.

Dr. Brimhall finishes his essay by stating we “…should become part of the health care solution and worry about distinction later.”

Sorry Joe, but the only way we are going to be part of the health care solution is through our distinction.

As always I look forward to your feedback, comments and suggestions.

Matthew McCoy DC, MPH
matthewmccoy@comcast.net
Editor
Journal of Pediatric, Maternal & Family Health - Chiropractic
http://www.chiropracticpediatricresearch.net

The Dangers of the Quack Therapy of Chiropractic Healing

Matthew McCoy DC MPH — Mon, 19 Apr 2010 21:18:00 GMT

I know you are busy but please take a moment.

I realize that much of your time is probably devoted to focusing on the needs of your patients and running your practice. That's a good thing.

But while you are doing that please realize that there are forces both within and outside of the chiropractic profession trying to stop you from being able to do just that.

Just recently the British Chiropractic Association lost a lawsuit against a self proclaimed skeptic of chiropractic for children. As stated in The Guardian:

"The British Chiropractic Association was suing him for saying that there was 'not a jot of evidence' that its members could help sick children by manipulating babies' spines in accordance with the teachings of a more-than-usually nutty American faith healer."

http://www.guardian.co.uk/commentisfree/2010/apr/18/nick-cohen-simon-singh-libel

Personally, I'm not interested in getting into what he should or should not be able to say at this point or how simply ignorant any of these people are - its a waste of time and you might as well try to teach pigs to sing. What I am interested in is putting to rest once and for all the question of whether or not chiropractic care is safe and effective for children.

And the only way that is going to happen is through research. Period.

And please don't write to me and tell me that we don't need to prove anything or that we just need to educate the public, blah, blah, blah.

If at this point in the dismantling of health care delivery you do not understand that we are moving rapidly into an outcomes based reimbursement system then you have your head buried in the sand. If we had another 100 years, doing it one spine at a time might work. But we don't have 100 years - we have 20 if we're lucky.

So do a couple of things RIGHT NOW:

1. Subscribe to this journal and support the authors, researchers and related efforts to get chiropractic research into the peer reviewed literature. Take a look at the literature that's been produced by these unsung heroes in just about a year and a half alone.
http://chiropracticpediatricresearch.web.officelive.com/subscribe.aspx

Subscribe now and we'll give you a free PowerPoint Titled: "How to Raise a Healthy Child in an Unhealthy World"

Then use it to do a lecture in your office next week, educate your patients, help others and grow your practice.

2. Join the ICPA and get involved in their Practice Based Research Network
http://icpa4kids.com/index.php

If you are already a subscriber to the journal and a member of the ICPA then please forward this to someone who may not be.

When it comes to the care of children the situation is serious and urgent. Can you imagine how much worse it would be if it were not for the ICPA and other groups and individuals fighting every day to ensure that children can get chiropractic care?

Do it now.

As always I look forward to your feedback, comments and suggestions.

Matthew McCoy DC, MPH
matthewmccoy@comcast.net
Editor
Journal of Pediatric, Maternal & Family Health - Chiropractic
http://www.chiropracticpediatricresearch.net

Is chiropractic in you or are you in chiropractic?

Matthew McCoy DC MPH — Wed, 07 Apr 2010 21:02:00 GMT

If you haven't heard the latest news in the health reform movement it is the announcement that Obama has appointed Donald M. Berwick as the Director for Medicare and Medicaid. I consider this to be very big news - even if he ends up being marginalized and has his hands tied for the next several years.

Why is this big news and why should we as chiropractors care about this?

I've been writing over the past few years that the chiropractic profession is in the midst of a 20 year perfect storm. The perfection is in the storm however - not necessarily its outcome. its made up of several things ocurring simultaneously within the profession, within the larger culture of health care and within the larger societal culture in which health care operates.

I rarely take a stand on an issue or espouse an opinion regarding an issue with an attitude of certainty. But on this issue I have few, if any, doubts.

This perfect storm includes the slow painful march towards payment for health care based on outcomes. That's where Berwick comes in - he is a leading, if not the leading, guru on this subject. When children born today reach their 30's and 40's they are going to look back at the dark ages of health care and wonder what the hell we were thinking. "You mean you had a system of health care where people actually paid for things that didn't even work?"

With all its faults organized medicine does not have the outright disdain for research that our profession has. So while its going to be painful for them to go through this - its nothing compared to what our profession is about to experience. You are going to have spent $200,000.00 and 6-8 years of your life to treat a very narrow range of neck pain, back pain and headaches. Release the imprisoned impulse? LOL. The general disdain for research in this profession is bad enough - within the various subluxation based factions it is even worse.

Add to this that within chiropractic we have the 40% decline in chiropractic college enrollment that has ocurred over the past decade.

I predict that several of the smaller chiropractic programs are going to fold up their tents in the next 5-10 years which will consolidate enrollment in just a handful of larger schools. I predict that enrollment will remain flat, as it has for several years, and even inch downward a bit.

This will happen for a few intertwined reasons. Students no longer enter chiropractic soley because they had a personal experience that changed their lives or because they had a family member who got them into the profession. Most are entering because they simply made a career choice. The savvy health sciences student absent a life changing chiropractic event or being brought up in the TIC is considering chiropractic, osteopathy, medicine, physical therapy, pharmacy, dentistry etc in terms of a career choice.

The savvy potential student is weighing the costs of a chiropractic education with what he will get at the other end. Given that it costs about the same $200,000.00 to become an osteopath or MD as it does to become a chiropractor and given the perks, discounts and sign on bonuses being offered by pharmacy programs and drug stores to become a pharmacist, and given that physical therapists are now doctors, have primary care status and are fully integrated into the health care system - the potential chiropractic student has much to weigh.

Chiropractic's move away from being drugless and its embracing of the primary care physician designation in order to get paid for more codes has just further diluted our brand. On the other end of the spectrum there is the move to present oursleves as all things "wellness" to the public when we don't own the patent on that either. Why spend $200,000.00, four years, four parts of the National Boards etc to do what any gym rat or stay at home mom can do? $200,000.00 to tell people to eat right, exercise, get proper rest and have a positive attitude?

I spoke to a graduating student recently with $200,000.00 in student loans who was asking advice about what to do after graduation. His plans included setting up a practice by borrowing over a $100,000 with his parents co-signing and putting up collateral. Oh, and by the way his wife is also about to graduate as a chiro, and they just had a baby and are buying a house. Nearly a million dollars in debt between them and they haven't seen a single new patient yet.

Our profession needs to take a serious look at itself politically, academically and research wise if we are going to survive this storm. And I'm not talking about individual chiropractors. I know very well that an individual chiropractor can see hundreds of patients a week and make millions of dollars a year. But the average chiropractor won't - and those seeing 500, 600, 1000 a week (and getting paid for each visit - not the $10 and I'll see your whole family BS) are in the tail of that normal distribution. Yes, its possible - but not probable.

And just where are those 1000 + a week practitioners in terms of the politics of the profession? Are they speaking up about the direction a small rogue faction of the profession is taking us? What about the groups that train them? Are they mobilizing their armies of chiropractic warriors to unseat the entrenched powers in the profession? Are they donating gobs of money to fund the research we are going to need in order to even be an afterthought in the coming outcomes based healthcare system?

Because it is coming whether we like it or not. And its coming no matter how hard we click our heels together and wish we were back in Kansas.

Will this third generation of chiropractors be the last? Will those in the second generation who made money in the Mercedes 80's and now make it by running schools, teaching students how to run a practice after they graduate, and selling their wares to the new graduates dare upset the status quo? Will they worry more about the sacred trust and responsibility for the stewardship of the profession than they worry about their own retirement?

These are important questions as we arrive at the proverbial fork in the road.

Will we embrace our singular uniqueness in the marketplace or will we marginalize ourselves by becoming third rate providers of whatever we can sell today?

Is chiropractic in us or are we in chiropractic?

As always I look forward to your feedback, comments and suggestions.

Matthew McCoy DC, MPH
matthewmccoy@comcast.net
Editor
Journal of Pediatric, Maternal & Family Health - Chiropractic
http://www.chiropracticpediatricresearch.net

ICA Speaks Out Against Drugs & Tiering in the Profession

Matthew McCoy DC MPH — Sun, 28 Mar 2010 02:59:00 GMT

The ACA, National Board and the ACC Remain Silent

The International Chiropractors Association in a statement released this week expressed grave concern over the New Mexico Scope Expansion.

According to the ICA statement the expansion of scope has the potential of fundamentally changing the nature of chiropractic practice as well as confusing the public and possibly placing the public at risk at the hands of a new category of provider.

According to the ICA's press release:

• Public safety is in question
• Public understanding of chiropractic as a true alternative to drug-based approaches is in jeopardy
• The New Mexico law change represents a major paradigm shift for the chiropractic profession.
• Testing of the National Board of Chiropractic Examiners does not include testing for the credentialing of the practice of medicine.
• The Chiropractic Paradigm developed by the Association of Chiropractic Colleges (ACC) and endorsed by every chiropractic organization in the United States identifies chiropractic practice as being drug-free.

The ICA stated that action is needed to avoid damaging chiropractic nationwide and urged "...all organizations and institutions within the chiropractic profession to take a stand on this issue, supporting the maintenance of chiropractic as a drug-free profession, clearly distinct from the practice of medicine and to oppose the tiering of the chiropractic profession as is established in the New Mexico statute."

The ICA also strongly urged the National Board of Chiropractic Examiners (NBCE) to "...not give this initiative credibility by the establishment of any national exam to be used for the purposes of prescribing drugs and practicing medicine."

The American Chiropractic Association has gone on record supporting the creation of advanced designations for chiropractors and the National Board of Chiropractic Examiners is purportedly developing an exam for such purposes. The Association of Chiropractic Colleges has not issued any statements on the issue despite the fact that one of its members, National College, is heading up the Advanced Practice initiative.

As always I look forward to your feedback, comments and suggestions.

Matthew McCoy DC, MPH
matthewmccoy@comcast.net
Editor - Journal of Pediatric, Maternal & Family Health - Chiropractic
http://www.chiropracticpediatricresearch.net

Opposition to Tiering & Drugs in Chiropractic Heats Up

Matthew McCoy DC MPH — Thu, 18 Mar 2010 18:40:00 GMT

Life University President Opposed to Tiering
Georgia Chiropractic Council Calls for Investigation
Colorado Introduces Legislation

Several months after National University of Health Sciences announced its first graduating class of Advanced Chiropractic Physicians other chiropractors and groups are starting to speak out.

In an article published in the February/March issue of Today’s Chiropractic Lifestyle, Dr. Guy Reikeman, President of Life University states that “Tiering would take us back into fragmentation and disharmony” and says "I am opposed to tiering because I believe it’s healthy to accommodate a broad diversity of opinions within the profession and that those opinions and practice styles can be effectively managed under one chiropractic umbrella.”

Reikeman adds that the strongest proponents of tiering “…are often those who practice or educate at the most extreme philosophical ends of chiropractic and truly believe there are two professions in our midst.”

In a resolution rejecting the introduction of professional tiering, injections and prescription drugs into chiropractic the Georgia Chiropractic Council sharply denounced such activity, and stated it is opposed to any national certifying examination. It has been reported that the National Board of Chiropractic Examiners plans on developing such certifying exams.

The GCC further called for “…an investigation into the use of the American Chiropractic Physician Credentialing Center (ACPCC), a subsidiary of the American Academy of Chiropractic Physicians, as a "nationally recognized credentialing agency" for the purposes of certifying qualifications to practice medicine.”

The whole tiering thing has a long history in the profession but the most recent drive for this started in the late 90’s and early part of 2000 with the launch of the Journal of Chiropractic Medicine. One particular issue worth reading to bring you up to speed on where the profession is headed is the:

Volume 1(4); Fall 2002 issue.

Strength in diversity: Professional and legislative opportunities in primary care by the recognition, defining and promotion of the licensure of chiropractic medical education, competencies and skills
Reiner G. Kremer
J Chiropr Med. 2002 Fall; 1(4): 139–148. Published online 2002. doi: 10.1016/S0899-3467(07)60028-7.

Those more medically oriented chiropractors who are supportive of tiering have been attempting to portray the outrage regarding this latest move towards a formal splitting of the profession as much ado about nothing. Others have said it’s just an isolated event in one state and why make a big deal about it. Those folks should watch carefully what’s happening in Colorado.

The Colorado bill HB 1216:

"Concerning the off site administration of medications by persons authorized to inject medications pursuant to the Pharmacy Practice Act"

orginally included the following language:

DEVELOP BY RULE A SPECIFIC FORMULARY OF NUTRITIONAL REMEDIAL MEASURES THAT MAY BE ADMINISTERED BY A TRAINED CHIROPRACTOR TO FACILITATE AND MAKE ADJUSTMENT AND MANIPULATION IN THE TREATMENT OF NEUROMUSCULAR-SKELETAL CONDITIONS MORE EFFECTIVE. THE FORMULARY SHALL INCLUDE VITAMINS B, C, AND D; CHONDROITIN SULFATE; GLUCOSAMINE HYDROCHLORIDE; SALINE; DEXTROSE; LIDOCAINE; PROCAINE; HOMEOPATHIC PREPARATIONS; SARAPIN; AND EPINEPHRINE.

This language is no longer contained in the current version of the bill.

According to the article in Today's Chiropractic, Dr. Michael Brown - the President of the New Mexico Chiropractic Association - says as many as 19 other states are studying New Mexico's legislation and more than half the chiropractors enrolled in the advanced certification courses are from outside New Mexico.

Similar to the false idea that this is isolated, some have expressed that the leadership within the chiropractic colleges believe we can address philosophical differences without tiering - the President of National seems to have some other ideas about that and we have yet to hear from the Association of Chiropractic Colleges on this issue.

Those within the more conservative faction of our profession should remember the story of the frog and the scorpion when such attempts to placate us are made.

See below for more reading and information on this issue.

As always I look forward to your feedback, comments and suggestions.

Matthew McCoy DC, MPH
matthewmccoy@comcast.net
Editor – Journal of Pediatric, Maternal & Family Health - Chiropractic
http://www.chiropracticpediatricresearch.net

Additonal Links and Reading on the Tiering Issue

ICPA's Freedom for Family Wellness Summit

Matthew McCoy DC MPH — Wed, 10 Mar 2010 00:14:00 GMT

The ICPA's Freedom for Family Wellness Summit is scheduled for October 21-24, 2010 in Washington DC. I want to encourage you to submit an abstract for this conference. To assist you in preparing your research for this conference, the ICPA is offering you an opportunity to submit your abstracts for review.

The ICPA is well aware that doctors in practice often see the submission of research to be daunting, and they wish to encourage all interested doctors to submit a request for help if they wish to participate.

The ICPA is ready to assist your process of presenting your research at this conference and with thier assistance this year, is hoping that next year you will be in a position to help others who may be in a similar position to you at this time.

The instructions for preparing and submitting abstracts are available here.

When you have reviewed these guidelines, please submit your abstract using the online form here.

The deadline for submitting your abstracts is June 30, 2010.

If you have any questions, please feel free to contact Charles L. Blum, DC, ICPA Freedom for Family Wellness Summit Abstracts Coordinator at drcblum@aol.com

If you have any difficulties with submission, do not hesitate to contact pbrn@icpa4kids.com with any questions.

As always I look forward to your feedback ,comments and suggestions.

Matthew McCoy DC, MPH
matthewmccoy@comcast.net
Editor - Journal of Pediatric, Maternal & Family Health - Chiropractic
http://www.chiropracticpediatricresearch.net

Tiering or Tearing of the Profession?

Matthew McCoy DC MPH — Fri, 12 Feb 2010 15:19:00 GMT

By now you must have heard of what’s going on in New Mexico. Our brethren in the Southwest have decided they are “Advanced” chiropractic physicians. And just what’s so advanced about them – why they can inject stuff and have a limited pharmacopeia.

Some in the profession are shocked by this and mistakenly think that:

1. Its something new and
2. That the majority of the profession does not support such a move into allopathy.

Unfortunately both beliefs are false.

Volume 1(4); Fall 2002 issue.

The whole issue is worth reading if you want to understand where this fringe group wants to take the profession but one article in particular sort of lays it all out.

Strength in diversity: Professional and legislative opportunities in primary care by the recognition, defining and promotion of the licensure of chiropractic medical education, competencies and skills
Reiner G. Kremer
J Chiropr Med. 2002 Fall; 1(4): 139–148. Published online 2002. doi: 10.1016/S0899-3467(07)60028-7.

So, this is not a new thing.

Secondly, the belief that the rank and file of our profession wants to remain drug free is not consistent with the facts. In the study completed at Ohio Northern nearly half the respondents stated they wanted to be able to prescribe drugs.

So the folks in New Mexico are just pioneers in what will probably be copied in one way, shape or form throughout the country. Of course each state is different so there will have to be multiple approaches but no doubt they’ll work it out.

There is certainly no one standing in their way – have you heard an outcry from the profession about this? I haven't.

In fact the ACA endorses it and the NBCE is developing exams for such a purpose:

Yes, now student’s money is being used to pay for bringing drugs into our drugless profession. That loud rumbling you just heard was all those chiropractors who went to jail for this profession rolling over in their graves.

Some have spoken out – The Foundation for Vertebral Subluxation issued a statement on it.

Foundation for Vertebral Subluxation Statement on Tiering

Dr. Christopher Kent just wrote an as usual insightful article about it.

Drugs, Chiropractic and Boiled Frogs

The ICA has set up a Working Group to look into it:

Chiropractic Advanced Practice law Raises Questions of National Significance

And Dr. Don Harrison has also just released an article about it.

Tiering of the Chiropractic Profession - Geuss Who's Behind This?

Now - what are YOU going to do or say about it?

Here's some additional links on the topic:

As always I look forward to your feedback, comments and suggestions.

Matthew McCoy DC, MPH
matthewmccoy@comcast.net
Editor - Journal of Pediatric, Maternal & Family Health - Chiropractic
http://www.chiropracticpediatricresearch.net

David, Goliath, Benjamins and the Death of a Movement

Matthew McCoy DC MPH — Mon, 08 Feb 2010 22:41:00 GMT

2009 was quite a year with the health care reform debacle and the Swine flu fiasco taking up so much of the public discussion on health care. As we sink deeper into 2010, Swine flu seems to be an after thought now and Obama vows he’s not done with health care. We’ll see…

According to the Center for Responsive Politics, health care and insurance company lobbyists spent more than $648 million in 2009. A spokesman for the Center stated that the money spent last year on health care dwarfs the amount spent on any other single issue in a single year. In fact, he said, it was the most money ever spent by a business sector for federal lobbying.

Drug companies spent more than $245 million on lobbying last year alone with Pfizer contributing $22 million. $245 million is more than the combined budgets of all chiropractic institutions in the United States. The money spent by drug companies was more than any other single industry has ever spent on lobbying on behalf of any issue. One report stated this was $90 million more than the oil and gas industry spent on lobbying last year.

In addition to this $648 million another $210 million was spent on television advertising, according to Campaign Media Analysis Group. This amount also set a record for money spent on a single issue in a single calendar year.

The Pharmaceutical Research and Manufacturers of America spent $26 million on lobbying and another $130 million for a television campaign and the American Hospital Association spent $16.3 million on lobbying.

The United States Chamber of Commerce spent $144 million on lobbying and an additional $50 million on commercials.

Just to put this all in perspective, the chiropractic profession spent a whopping $525,000.00 on lobbying in 2009. Yes siree - half a million bucks. Here’s a breakdown of who spent what:

The David and Goliath story of chiropractic versus the medical pharmaceutical industrial complex was true 100 years ago and it’s still true today. Though the spirit of the profession seems crushed and we’ve gone from a movement to a bunch of old white guys making sure their golden years remain – well, golden. All the while the profession as a whole remains stuck in the lower levels of Maslow’s hierarchy of needs just trying to survive.

It would be nice to know what this half a million was spent on so we could see what the priorities of the profession really are but given the fact that a “United Profession” put forth the document The Path to Change in the US HealthCare System: The Chiropractic Perspective. A Joint Policy Statement on Healthcare Reform Presented by a United Chiropractic Profession as our two cents in the health care reform debate, its pretty clear where the cartel is taking us. For more on this see: Please Sir, I Want Some More.

As always I look forward to your feedback, comments and suggestions.

Matthew McCoy DC, MPH

matthewmccoy@comcast.net

Editor – Journal of Pediatric, Maternal & Family Health – Chiropractic

http://www.chiropracticpediatricresearch.net

Had your Swine Flu Shot yet?

Matthew McCoy DC MPH — Fri, 29 Jan 2010 16:07:00 GMT

Not too long ago I officially declared swine flu a fiasco. And while I did get some hate mail suggesting this meant I didn't care about those who did actually die from the disease, most agreed it was indeed a fiasco. In fact, at this point the agreement out there on just how mild it was is so widespread that anyone suggesting otherwise has not only drunk the Kool Aid but is mixing up batches of their own.

Nevertheless, I'll continue to post updates on swine flu happenings since Walgreens, CVS and a host of other doc in the boxes are now trying to unload their stockpiles of vaccines that finally arrived AFTER the worst was over. Interesting to me that these for profit companies can charge people for the vaccines considering that our tax doallrs paid for them to begin with - I suppose its a needle sticking fee?

Yes, from a governmental bailout of vaccine production and distribution to the dissolution of personal autonomy brought on by changes in federal and state laws - it is quite shocking and quite encouraging how people both functioned as automatons on the one hand and resisted the government and pharmaceutical propaganda on the other.

But we'll see. Flu season is not over and there's always next year - and with a re-tooled and re-energized vaccination industry.

Click here for recent headlines related to the flu and vaccines.

As always I look forward to your feedback, comments and suggestions.

Regards,
Matthew McCoy DC, MPH
matthewmccoy@comcast.net
Editor - Journal of Pediatric, Maternal & Family Health - Chiropractic
http://www.chiropracticpediatricresearch.net

Swine Flu is Officially a Fiasco

Matthew McCoy DC MPH — Thu, 10 Dec 2009 03:15:00 GMT

Its official and I’m declaring it. The 2009 Swine flu “pandemic” is a bonafide fiasco. A fiasco is a complete failure - an ignominious, humiliating and disgraceful failure. All the evidence at this point clearly shows that from the government to public health to the pharmaceutical industry - nothing panned out the way they predicted it would.

In a recently released report:

Presanis AM, De Angelis D, Hagy A, Reed C, Riley S, et al. 2009 The Severity of Pandemic H1N1 Influenza in the United States, from April to July 2009: A Bayesian Analysis. PLoS Med 6(12): e1000207. doi:10.1371/journal.pmed.1000207

According to these researchers (which include scientists from Harvard, the UK Medical Research Council and the Centers for Disease Control and Prevention) H1N1 swine flu won't be as severe as was feared and when the fall and winter wave of H1N1 swine flu is over, it will have been no more severe than an average flu season.

In fact, according to one of the researchers - Dr. Lipsitch “The good news is that ... the severity of the H1N1 flu may be less than initially feared."

Let's not forget that the White House predicted as many as 90,000 dead and such dire predictions set the stage for the rolling back of all sorts of civil liberties along with the spending of billions of dollars of taxpayer money that went directly into the pockets of drug companies that were absolved of any risk from adverse reactions from the vaccines they manufactured.

We are just getting the first reports of those adverse reactions. Of course there have been the multiple reports on the internet of anaphalactic reactions and neurological disorders immediately following vaccination but now we have more “authoritative” reports from the CDC and the Vaccine Adverse Events Reportiong System (VAERS).

According to this report:

CDC and FDA staff members searched the VAERS database to identify all U.S. reports of adverse events after vaccination with H1N1 vaccines and 2009--10 seasonal influenza vaccines during July 1--November 24.
3,783 reports of adverse events were received through the U.S. Vaccine Adverse Event Reporting System through November 24 after receipt of H1N1 vaccine. Of these 204 were categorized as serious. In addition, 4,672 adverse events reports after receipt of seasonal influenza vaccines were received, of which 283 were serious.
VAERS data indicated 82 adverse event reports per 1 million H1N1 vaccine doses distributed, compared with 47 reports per 1 million seasonal influenza vaccine doses distributed.
They excluded 62 reports due to “insufficient” information.
During October 5--November 20, a total of 46.2 million doses of H1N1 vaccines and 98.9 million doses of seasonal influenza vaccines were distributed to U.S states and territories. (The government was originally hoping to vaccinate 100 million Americans with H1N1).
The serious adverse event reporting rates were 4.4 and 2.9 serious adverse events per 1 million doses distributed for H1N1 vaccines and seasonal influenza vaccines, respectively.
VAERS received 13 reports of deaths occurring after receipt of H1N1 vaccine. In nine of these deaths, significant underlying illness was reported.
There were 10 reports of Guillain-Barré syndrome, and two additional reports of possible Guillain-Barré syndrome identified by medical officers reviewing other reports to VAERS describing neurologic events.
VAERS also received 11 reports of anaphylaxis, and an additional eight reports of possible anaphylaxis were identified by medical officers reviewing reports to VAERS of serious allergic events.
Three of the Guillain-Barré syndrome cases and 15 of the anaphylaxis cases were coded as serious adverse events, in accordance with federal regulation.
The remaining 173 nonfatal serious adverse events after vaccination with H1N1 vaccines are under chart review. These reports fall into the following diagnostic categories: neurologic or muscular condition other than Guillain-Barré syndrome (49 [28%]); pneumonia or influenza-like illness (27 [16%]); other noninfectious conditions, including multiple medical symptoms (19 [11%]); respiratory or ear, nose, and throat condition (17 [10%]); allergic conditions other than anaphylaxis (16 [9%]); pregnancy complications** (15 [9%]); other infectious symptoms (10 [6%]); gastrointestinal (eight [5%]); cardiovascular (six [3%]); and psychiatric (six [3%]).

Remember all those news conferences where they told us how safe the vaccine was?

Adding to the evidence that H1N1 fears were overblown can be found in a report just published in the New England Journal of Medicine. Surveillance of the 2009 H1N1 virus in China shows that the majority of those infected had a mild illness.

Adding salt to the wounds is an Editorial in the NEJM on the need for science in the practice of public health. The author states that to date H1N1 has not been as lethal as first feared.

Luckily, for the most part, the public didn’t buy into the fear and manipulation churned out by the media, the government and the drug companies. Thankfully we also have the internet and unconventional forms of information distribution. If all we had were the big three networks, cable news and Sanjay Gupta to rely on to give us the truth, no doubt many more would have died or been permanently injured from this fiasco.

The only thing that’s left to do is to hold the congressional hearings on why this was allowed to happen and which heads need to roll. Considering that they spent taxpayer dollars to investigate baseball players taking steroids, one could assume that something so much bigger, so much more damaging to the public health and trust and something people actually care about could warrant congressional hearings.

Don’t worry – I’m not holding my breath.

As always I look forward to your feedback, comments and suggestions.

Matthew McCoy DC, MPH
matthewmccoy@comcast.net
Editor - Journal of Pediatric, Maternal & Family Health - Chiropractic
http://www.chiropracticpediatricresearch.net/

Swine Flu - Much Ado About Nothing?

Matthew McCoy DC MPH — Thu, 19 Nov 2009 22:06:00 GMT

What if you had a pandemic and no one came?

Just change the way you measure those infected. In a remarkable development the CDC has announced that they are going to change the way that Swine flu cases are defined. It seems the grand total of 1200 deaths from H1N1 wasn't sufficiently scaring the hell out of people enough to go out and get vaccinated so why not bump up the numbers to put a chill in the air?

While the news media is widely reporting long lines at clinics for the vaccine other sources suggest a different story. In New York last week officials were prepared to administer 31,500 vaccinations a day at seven free clinics throughout the city. The total vaccinations administered on Saturday was 1,701. The New York Times reported vaccine workers standing around with nothing to do and officials perplexed by the low turnout.

Meanwhile government officials and vaccine manufacturers were hauled before Congress which was investigating why so little vaccine had made it to the public and here we are dead in the middle of the season. Everyone blamed those slow virus growing chicken eggs, the public’s fear of vaccines and regulatory hurdles that won’t allow them to use adjuvants. Only 49 million doses had been delivered by this week.

All of this doesn’t seem so much a mystery to me. The drug companies were paid ahead of time to produce the vaccines, surveys of your average earthling revealed that more than half would not get the vaccine, low turnouts materialized so why would the vaccine manufacturers spend any more money to produce more vaccine when they probably won’t be able to get what they will produce off their shelves by the end of the season?

$1.5 billion was paid by the US government for Swine flu vaccine – that’s $600 per taxpayer. In what seems incredible Glaxo won’t tell what they are getting from the UK government for its H1N1 concoction and Baxter settled out of court after accusations of fraud for overcharging for their Swine flu vaccine. Despite this Britain still went ahead and contracted with them for 132 million doses!

Its like getting vaccine out of the back of a panel van in the alley from your local neighborhood criminal.

And these are the people we are supposed to trust when they tell us to just roll up our sleeve and get in line? I'm sure such criminal behavior would never spill over into the science or manufacturing of the vaccine - right?

Despite the changes in definitions to bump up the numbers some experts don’t seem to think there is anything to worry about. Ira M. Longini Jr., a flu epidemiologist at the University of Washington and Michael T. Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, both said the new figure doesn’t come close to the 90,000 people Obama said would drop dead this flu season.

In fact according to Dr. Longini deaths were likely to be in the 30,000-to-40,000 range, and Osterholm said they would “have a long way to go to even get there.”

Sounds like a typical flu season to me.

As always I look forward to your feedback, comments and suggestions.

Matthew McCoy DC, MPH
matthewmccoy@comcast.net
Editor - Journal of Pediatric, Maternal & Family Health - Chiropractic
http://www.chiropracticpediatricresearch.net

Swine Flu Vaccine & Pregnant Women

Matthew McCoy DC MPH — Fri, 13 Nov 2009 16:27:00 GMT

There is no doubt a great deal of information being thrown at us every day in regards to the Swine flu. Just deciding what is important to focus on takes a great deal of time and effort. For this update I am going to focus on the news widely reported in the media that results from a clinical trial indicates that the vaccine is safe in pregnant women. As soon as this came out the media were all over it and public health officials were once again making a mockery out of those women who were choosing not to vaccinate themselves out of concern for the untested vaccine.

Let’s walk slowly through the data as reported by the National Institutes for Allergy and Infectious Disease.

1. This clinical trial is studying only 120 women
2. There are two groups with only 60 subjects in each group
3. They are getting two doses of the vaccine with one group getting a larger dose than the other.
4. They are 18 to 39 years of age
5. They are in their second or third trimester (14 to 34 weeks) of pregnancy
6. The vaccine is a candidate 2009 H1N1 influenza vaccine manufactured by Sanofi Pasteur.

In order to be in this study these women must be in good health. They determine good health as follows:

By vital signs (heart rate 100 beats per minute; blood pressure: systolic 140 mm Hg; diastolic less than or equal to 90 mm Hg; oral temperature 100 degrees Fahrenheit), medical history to ensure any existing medical diagnoses or conditions are stable and not considered clinically significant, and targeted physical examination based on medical history. A stable medical condition is defined as health outcomes of the specific disease are considered to be within acceptable limits in the last 3 months.

Here is a list of all the women EXCLUDED from the study:

• Has a known allergy to eggs or other components in the vaccines (these may include, but are not limited to: gelatin, formaldehyde, octoxinol and chicken protein).
• Has a history of severe reactions following previous immunization with influenza virus vaccines.
• Has participated in a novel influenza H1N1 2009 vaccine study in the past 2 years or has history of novel influenza H1N1 2009 infection prior to enrollment.
• Has received any other live licensed vaccines within 4 weeks or inactivated licensed vaccines within 2 weeks prior to vaccination in this study prior to vaccination or plan receipt of such vaccines within 21 days following the last vaccination (except for seasonal inactivated influenza vaccine which may be received 2 weeks post either vaccination). Measles, mumps, and rubella vaccine and tetanus, diphtheria, and acellular pertussis vaccine are permitted post-partum.
• Has received an experimental/investigational agent (vaccine, drug, biologic, device, blood product, or medication) within one month prior to vaccination in this study, or expects to receive another experimental/investigational agent during the study period (prior to the Day 201 follow-up call - 180 days after the second vaccination).
• Has an acute illness and/or an oral temperature greater than or equal to 100.0 degrees Fahrenheit, within 72 hours of vaccination (This may result in a temporary delay of vaccination).
• Has immunosuppression as a result of an underlying illness or treatment, or use of anti-cancer chemotherapy or radiation therapy within the preceding 36 months.
• Has an active neoplastic disease (excluding non-melanoma skin cancer), a history of any hematologic malignancy, current bleeding disorder, or taking anticoagulants.
• Long term use of glucocorticoids, including oral or parenteral, or high-dose inhaled steroids (>800 micrograms/day of beclomethasone dipropionate or equivalent) within the preceding 6 months (nasal and topical steroids are allowed) or has received betamethasone or dexamethasone to accelerate fetal lung maturity.
• Has a history of receiving immunoglobulin or other blood product (with exception of Rhogam) within the 3 months prior to enrollment in this study.
• Has a diagnosis of a current and uncontrolled major psychiatric disorder.
• Has been hospitalized for psychiatric illness, history of suicide attempt, or confinement for danger to self or others, within the past 10 years.
• The subject is receiving any of the following psychiatric drugs: aripiprazole, clozapine, ziprasidone, haloperidol, molindone, loxapine, thioridazine, thiothixene, pimozide, fluphenazine, risperidone, mesoridazine, quetiapine, trifluoperazine, trifluopromazine, chlorprothixene, chlorpromazine, perphenazine, olanzapine, carbamazepine, divalproex sodium, lithium carbonate or lithium citrate. Subjects who are receiving an antidepressant drug (not listed above) and are stable for at least 3 months prior to enrollment without decompensating are allowed enrollment into the study.
• Known active human immunodeficiency virus (HIV), hepatitis B, or hepatitis C infection.
• History of alcohol or drug abuse in the last 5 years.
• Has a seizure disorder or is on an anti-seizure medication.
• Has a history of Guillain-Barré Syndrome.
• Plan to travel outside of North America in the time between the first vaccination and 42 days following the first vaccination.
• Has an acute or chronic medical condition that, in the opinion of the investigator would render vaccination unsafe, or would interfere with the evaluation of responses (this includes, but is not limited to, known cardiac disease, chronic liver disease, significant renal disease, unstable or progressive neurological disorder, transplant recipients or uncontrolled diabetes, juvenile diabetes (Type I) or advanced diabetes with renal disease or eye disease, diabetes controlled by diet or insulin is acceptable.)
• Has any condition that would, in the opinion of the site investigator, place the subject at an unacceptable risk of injury or render the subject unable to meet the requirements of the protocol.

In terms of adverse outcomes they are looking at:

• The occurrence of solicited local and systemic adverse events within 8 days post vaccination.
• The incidence of maternal and neonatal complications at the time of delivery. (Emphasis added)

So what does the data from the study show so far?

• In 25 women who received a single 15-microgram dose of the vaccine, the H1N1 flu vaccine elicited an immune response likely to be protective in 92 percent, or 23 of 25, of these women.
• In 25 women who received a single 30-microgram dose of the vaccine, the H1N1 flu vaccine elicited an immune response likely to be protective in 96 percent, or 24 of 25, of these women.

So in 8 and 4 percent of women an immune response likely to be protected was not illicited - extrapolate that to the millions who might get the vaccine. They also note that the vaccine appears (emphasis added) to be well-tolerated, and no safety concerns related to the vaccine have arisen.

So what do we really know at this point? We know that in a small group of 50 healthy, pregnant women in their 2nd or third trimester an immune response to the vaccine was illicited in the majority of these women - some did not.

The report did not reveal whether or not there were local or systemic adverse events within the 8 days following vaccination – they just said no safety concerns had arisen. And they either have no data on maternal or neonatal complications yet or they just didn’t report on them, or they lump these into their “no safety concerns” statement. Note that they are not going to follow these women and children after delivery to see what if any long term effects occur months or years afterwards.

Interestingly the NIAID quotes Anthony Fauci MD stating: “For pregnant women, who are among the most vulnerable to serious health problems from 2009 H1N1 infection, these initial results are very reassuring,”

What Fauci leaves out is that the best data we have on how H1N1 effects preganant women is from studies just published based on data from the United States, New Zealand and Australia.

These data show that 30% of the pregnant women who died from H1N1 were either obese or morbidly obese and 60% had underlying medical conditions that put them at greater risk of overwhelming viral and bacterial infections.

So how can Facui make a blanket statement that all pregnant women are the most vulnerable when the data says otherwise? And then to recommend the vaccine to every single pregnant woman in the country based on the response in a healthy cohort of an incomplete study? Science at its best – or perhaps worst.

The best advice I can give at this point is: In God we trust – everyone else has to bring data.

As always I look forward to your feedback, comments and suggestions.

Matthew McCoy DC, MPH
matthewmccoy@comcast.net
Editor – Journal of Pediatric, Maternal & Family Health – Chiropractic
http://www.chiropracticpediatricresearch.net

Special Offer!

If you are not a subscriber - we need your help and support - the situation is critical. In order to make your decision easier please take advantage of this special Fall offer to become a subscriber. If you subscribe to the journal now I will send you absolutely free a PowerPoint presentation titled: The Flu: Sorting Fact From Fiction.

This presentation covers the reality and the facts about the seasonal flu, the flu vaccine, chiropractic and immune function. It can be used as a stand alone lecture or as part of an already existing lecture to educate your patients and community about the facts surrounding this issue.

The debate about the flu and vaccines will be going on for awhile and you should be informed about the facts so that you can answer your patient's questions as an authority on the issues.

The crucial need for chiropractic research alone should compel you to subscribe and support the efforts of those in the profession trying to gather the data to support what you do day in and day out but hopefully this added special offer will make it a no brainer. Your actions today help support needed research for the future.

Subscribe today and receive the free PowerPoint presentation: The Flu: Sorting Fact From Fiction as a free gift.

CLICK HERE TO SUBSCRIBE